The Effect of Platelet-Rich Fibrin on Block, Crushed and Diced Cartilage.

Abstract

BACKGROUND: In nasal surgery, autologous cartilage grafts are routinely used to correct structural weakness, contour deformities, and irregularities, yet current techniques still face challenges related to long-term cartilage graft viability and resorption. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that may improve graft survival through its sustained release of bioactive molecules within a natural fibrin matrix. OBJECTIVE: To evaluate the biochemical and histopathological effects of combining PRF with autologous cartilage grafts of different forms (block, crushed, and diced) in a rabbit model and to determine which combination provides optimal cartilage viability and matrix stability. METHODS: Twenty-four New Zealand rabbits divided into six groups based on their form: block, crushed, and diced. PRF was applied to three groups, while the remaining three served as controls. The grafts were placed in subcutaneous pockets on the rabbits' backs and harvested after 8&#xa0;weeks for histopathological and biochemical analyses. Cartilage tissues, growth factors, matrix components, angiogenesis, oxidative stress, and apoptosis markers were evaluated. RESULTS: PRF-treated groups demonstrated significantly higher growth factor levels, antioxidant status, lower oxidative stress and apoptosis markers compared with controls (p&#x2009;<&#x2009;0.05). Histological analyses showed better cellular proliferation and extracellular matrix preservation, particularly in PRF-combined diced and block cartilage grafts, whereas crushed cartilage exhibited marked degeneration. CONCLUSION: PRF enhanced the viability, proliferation, and angiogenic response of autologous cartilage grafts through its sustained release of growth factors and scaffold-like fibrin matrix. These findings suggest that PRF may improve graft stability and reduce postoperative complications in nasal surgery. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .